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Objective: To evaluate foot disability both ultrasonographically and by using the Foot Function Index (FFI) in patients with axial spondyloarthritis (SpA) and to investigate its effects on patients' quality of life and functional capacity by determining the factors that may affect the level of disability.Patients and methods. A total of 100 patients were included in the study. Enthesis sites in the feet were assessed for tenderness and swelling. Ultrasonographic examination of the Achilles tendon and plantar fascia was made and the findings were scored according to Glasgow Ultrasound Enthesitis Scoring System (GUESS). The Foot Function Index (FFI) was used to investigate the effects of foot disorders on disability and activity limitation. The correlation between GUESS and FFI scores, and relationship of GUESS and FFI scores with age, disease duration, body mass index (BMI), smoking and disease activity parameters were investigated.Results and discussion. Physical examination revealed signs of enthesitis in 13 (13%) patients, while ultrasonographic (USG) evaluation – in 36 (36%) patients. A statistically significant correlation was found between all FFI and GUESS scores except between FFI for the right foot and GUESS for right Achilles tendon enthesitis. A positive correlation was found between age and BMI and FFI (p<0.05). There was no correlation between disease duration and smoking and FFI scores. While there was a statistically significant correlation between all scores of GUESS and age, disease duration, and BMI, no correlation was found between smoking and GUESS scores. No significant difference was found in either FFI or GUESS scores between patients with or without / diabetes and patients who were smokers or non-smokers. All FFI and GUESS scores significantly correlated with BASDAI, ASDAS, BASFI, and ASQoL (p<0.05).Conclusion. Enthesitis may lead to decreased functional capacity and loss of quality of life in ax-SpA patients. Subclinical enthesitis in the feet of patients with SpA is not rare and may be detected by USG.

BackgroundPatients with rheumatoid arthritis (RA) have increased morbidity and mortality due to cardiovascular (CV) comorbidities.ObjectivesThe association of CV diseases (CVD) and traditional CV risk factors have been debated, depending on patient and RA characteristics. This study aimed to find the prevalence of CVD and CV risk factors in patients with RA.MethodsA multi-center cross-sectional study was performed on RA patients using the BioSTAR (Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs Registry). Socio-demographic, clinical, and follow-up data were collected. Patients with and without major adverse cardiovascular events (MACE) were grouped as Group 1 and Group 2. Prevalence rates of CVD and traditional CV risk factors were the primary outcomes. Secondary outcomes were the differences in the clinical characteristics between patients with and without CVD.ResultsWe analyzed 724 RA patients with a mean age of 55.1 ±12.8 years. There was a female preponderance (79.6%). The prevalence rate of CVD was 4.6% (n=33). The frequencies of the diseases in the MACE category were ischemic heart disease in 27, congestive heart failure in 5, peripheral vascular disorders in 3, and cerebrovascular events in 3 patients.The patients with CVD (Group 1) were significantly male, older, and had higher BMI (p=0.027, p<0.001, and p=0.041). Obesity (33.4%) and hypertension (27.2%) were the two CV risk factors most frequently. Male sex (HR=0.085, 95% CI:0.028-0.257, p<0.001) and hypertension (HR=4.63, 95% CI:1.251-17.134, p=0.022) were the independent risk factors for CVD.ConclusionThe prevalence of CVD in RA patients was 4.6%. Some common risk factors for CVD in the general population, including male sex, older age, and hypertension, were evident in RA patients. sex and hypertension were the independent risk factors for developing CVD in patients with RA.References[1] Raj R, Thomas S, Gorantla V. Accelerated atherosclerosis in rheumatoid arthritis: a systematic review. F1000Res. 2022;11:466.[2] Charles-Schoeman C, Buch MH, Dougados M, et al. Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. 2023;82(1):119-129.Table 1.Socio-demographic and clinical characteristics of the study groups.Overall (n=724)Group 1 (n=33)Group 2 (n=691)pAge group‡<40 years92 (12.7)0 (0)92 (13.3)0.015≥40 years632 (87.3)33 (100)599 (86.7)Sex‡Male148 (20.4)12 (36.4)136 (19.7)0.027Female576 (79.6)21 (63.6)555 (80.3)BMI group‡<30 kg/m2482 (66.6)17 (51.5)465 (67.3)0.087≥30 kg/m2242 (33.4)16 (48.5)226 (32.7)Smoking‡Current smoker101 (14.1)1 (3.0)100 (14.7)0.071Alcohol‡Current consumer21 (3.0)2 (6.3)19 (2.8)0.248Educational status‡Illiterate/primary448 (61.9)22 (66.7)426 (61.6)0.865High school202 (27.9)9 (27.3)193 (27.9)University or higher73 (10.1)2 (6.1)71 (10.3)Comorbidities‡Hypertension197 (27.2)22 (66.7)175 (26.6)<0.001Diabetes mellitus100 (13.8)12 (36.4)88 (13.7)0.001Chronic renal failure23 (3.2)5 (15.2)18 (2.9)0.004Dyslipidemia61 (8.4)11 (44.0)50 (11.9)<0.001COPD39 (5.4)6 (18.2)33 (4.8)0.007Coagulopathy6 (0.8)3 (10.3)3 (0.5)0.002Malignancy12 (1.7)2 (6.3)10 (1.6)0.113Valvular heart disease11 (1.5)2 (6.1)9 (1.3)0.256†: median (min-max),‡: n (%)Group 1 and 2: Patients with and without major adverse cardiovascular event (cardiovascular disease).BMI: body mass index, COPD: chronic obstructive pulmonary disease.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Herediter multiple ekzostoz, çoğunlukla uzun kemiklerin juksta-epifizer bölgesinden köken alan ekzositozlarla karakterize otozomal dominant bir hastalıktır. Hastalar en sık eklem yakınında tek veya çok sayıda sert, ağrısız kitlelerle prezente olur. En yaygın komplikasyonları ağrı, eklem hareket kısıtlılığı, ekstremite eşitsizlikleri, büyüme geriliği, damar-sinir basısı ve malign dejenerasyondur. Bu yazıda, herediter multiple ekzostoz tanılı bir olguyu sunmayı ve ilgili literatür eşliğinde klinik özelliklerini ve tedavide rehabilitasyonun etkinliğini tartışmayı amaçladık.